The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital
Provenzano, Bruna Cuoco; Bartholo, Thiago; Ribeiro-Alves, Marcelo; Santos, Ana Paula Gomes dos; Mafort, Thiago Thomaz; Castro, Marcos Cesar Santos de; Oliveira, Jose Gustavo Pugliese de; Bruno, Leonardo Palermo; Lopes, Agnaldo José; Costa, Claudia Henrique da; Rufino, Rogerio.
Rev. Assoc. Med. Bras. (1992)
; 67(7): 997-1002, July 2021. tab
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| LILACS | ID: biblio-1346931
SUMMARY
OBJECTIVE:
This study aims to analyze the risk factors for in-hospital mortality in a cohort of patients admitted to a newly adapted intensive care unit in a public hospital in Rio de Janeiro.METHODS:
This was an observational, retrospective, and descriptive study. Data were obtained from electronic medical records. Coronavirus disease 2019 (COVID-19) was diagnosed by detecting viral ribonucleic acid using reverse transcription polymerase chain reaction. Factors associated with the risk/protection from death were determined using the odds ratio and adjusted odds ratio.RESULTS:
Fifty-one patients were admitted to the hospital. The median age of the patients was 63 years, 60% were male patients, and 54% were white patients. Sixty-seven percent of the patients were diagnosed with COVID-19. Sepsis at admission increased the chance of in-hospital death by 21 times (adjusted odds ratio=21.06 [0.79-555.2]; p=0.06). The strongest risk factor for death was the development of septic shock during hospitalization (adjusted odds ratio=98.56 [2.75-352.5]; p=0.01), and one in four patients had multidrug-resistant bacteria. Mechanical ventilation, vasopressors, neuromuscular blockers, and sedatives were also the risk factors for in-hospital mortality. The in-hospital mortality rate was 41%, and the mortality rate of patients on mechanical ventilation was 60%. The diagnosis of COVID-19 was not statistically related to the adverse outcomes.CONCLUSIONS:
In this cohort, the strongest risk factor for in-hospital death was the development of nosocomial septic shock. Healthcare-associated infections have a significant impact on mortality rates. Therefore, to have a better outcome, it is important to consider not only the availability of beds but also the way healthcare is delivered.
Biblioteca responsable:
BR1.1
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